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Monday, December 20, 2010

PRESIDENT SIGNS BILL AVERTING MEDICARE CUTS

President Barack Obama signed the bill that eliminates the planned 25-percent cut in physicians’ Medicare fees for 2011, a move that will save Texas physicians about $1.5 billion over 13 months — $30,000 per physician — the American Medical Association says. Once again, we are back in the usual starting gates. Once again, last-minute legislation put off a cut. Once again, we have bought some time to devise a permanent replacement for the sustainable growth rate (SGR) formula that drives the cuts every year — which is a top TMA priority. Once again, Washington politicians are promising not to squander the window of opportunity. “It’s time for a permanent solution that seniors and their doctors can depend on, and I look forward to working with Congress to address this matter once and for all in the coming year,” the president said as he signed the bill. We’ll see.

BLUE CROSS SETS ONLY EDUCATION SESSION ON NEW PHYSICIAN EVALUATION PLAN FOR WEDNESDAY

Blue Cross and Blue Shield of Texas (BCBSTX) is rolling out a new product called BlueOptions. This product takes the physicians who have been evaluated under BlueCompare and adds a PCA (Physician Cost Assessment) review. TMA has been urging BCBSTX to provide Texas physicians an educational webinar on both PCA and BlueOptions. We learned late last week that the company has scheduled one such educational session for this Wednesday, Dec. 22, from 1 to 2:30 pm, Central Time. We have asked BCBSTX to record the webinar or offer additional sessions. In the meantime, please share this information with your colleagues:

WHAT'S YOUR STORY?

The patient-physician relationship is medicine’s secret weapon. We need to make it not so secret. Every physician has a story. What’s yours? On the TMA website, we’ve posted a very short video from Fort Worth pediatrician Gary Floyd, MD. He tells a story only a physician can tell: what it means to be someone’s doctor, the trusting relationship between physician and patient. Every Texas physician has a story like this. We want to share these stories ... with lawmakers and the public. The power in these stories will help them understand the problems in medicine today and how we hope to solve them. So, what’s your story? Why did you go to medical school in the first place? Do you remember that patient encounter that brought it all home to you? The patient you think of when times are tough? Tell your story to a video camera. We don’t care if it’s your cell phone, or a flip camera, or a full-featured video recorder. Just “get it down on film” and send it our way. TMA has set up a special YouTube channel where you can upload your story. Just follow the simple directions at www.texmed.org/yourstory.aspx.

TMA, AMA CALL FOR FEDS TO TAKE ACTION ON MEDICARE BACK PAY, E-PRESCRIBING

TMA has joined with AMA and state and specialty societies across the country in a letter asking Health and Human Services Secretary Kathleen Sebelius to pay physicians overdue Medicare fees. We’re calling on the Centers for Medicare & Medicaid Services to use the $200 million Congress allocated to provide physicians long-overdue Medicare payments they should have received earlier this year. “After weathering a year filled with uncertainties from continuous threats of cuts to Medicare payments, many physicians are not in a position to rely on IOUs from the government,” said AMA President Cecil Wilson, MD. We joined in a second letter asking Secretary Sebelius to revise Medicare’s e-prescribing penalties. That policy, which would penalize physicians in 2012 if they don’t e-prescribe in the first six months of 2011, will hurt efforts to implement widespread health information technology adoption among physician practices and cause them to take on needless financial and administrative burdens. 

FIRST TMA LEADERSHIP SERIES WEBINAR NOW ONLINE

The first webinar in the TMA Leadership Series — “How TMA Makes Policy,” featuring an introduction by House of Delegates Speaker Steve Brotherton, MD — is now available for you to watch free on the TMA website. This webinar series, sponsored by Pfizer, was originally conceived as part of the TMA Leadership College course requirement, but we have opened it for any Texas physician to watch. Coming over the next few weeks will be two more free leadership webinars:
  • “Rules, Rights, and Powers: A Look at County Medical Society Bylaws,” with Holly Alt, JD, presenting; and
  • “How to Run an Effective Meeting,” with Robert Strauss, MD, presenting.
We will seek another grant from Pfizer to create three additional webinars next year. Which topics would you would like to see in 2011? Let me know.

HAPPY HOLIDAYS FROM EVPGRAM; SEE YOU NEXT YEAR

It’s a bit late in December, but EVPGram will take its annual holiday holiday over the next two weeks. We’ll be back in your inboxes on Monday, Jan. 10 — the day before the 2011 Texas Legislature convenes. I wish everyone a happy holiday season and a healthy new year.

Monday, December 13, 2010

ANOTHER MEDICAID CUT COMING FEB. 1

Responding to orders from top leaders trying to stanch the impact of the pending $25-billion-plus state budget shortfall, the Texas Health and Human Services Commission (HHSC) will chop Medicaid fees to physicians, hospitals, and providers by 1 percent effective Feb. 1. HHSC will cut payments to nursing homes and home health providers by 2 percent. Gov. Rick Perry, Lt. Gov. David Dewhurst, and House Speaker Joe Straus asked all state agencies to identify budget savings of 2.5 percent for the rest of fiscal 2011. A previous budget-cutting directive led HHSC to cut Medicaid fees by 1 percent on Sept. 1. “Identifying these savings builds on our ongoing call to keep government spending in check so that we can balance our state budget without raising taxes,” Governor Perry said.The new federal health law will make 1.5 to 2 million more Texans eligible for Medicaid beginning in 2014. Here’s how the report characterizes Texas’ ongoing predicament: “Without significant reform at the federal level, states are left facing a no-win dilemma. Opting out of Medicaid means giving up federal tax dollars paid by the state’s residents to provide health care for our most vulnerable residents. Staying in the program forces states to pay for a federally-mandated expansion of Medicaid with little control over the program’s ever-rising costs, exacerbating an already unsound financial situation.”

MEDICARE MELTDOWN DELAYED A FULL YEAR; WILL CONGRESS FIX IT BY THEN

In almost unanimous votes, the U.S. Senate and House of Representatives sent President Barack Obama a bill stopping the 25-percent cut in physicians’ Medicare payments that was scheduled for Jan. 1. Thanks to all physicians, medical students, and alliance members who took the time to write or call their senators and representatives, urging them to stop the Medicare Meltdown. I also encourage you to thank your Medicare patients, especially those who are members of AARP, for lobbying Congress to stop the cut. Unfortunately, lawmakers did what they have done for the past decade — postpone a scheduled cut, this time for a year — instead of fixing the payment system permanently. “More than 3.3 million Texas seniors, people with disabilities, and military families deserve a sustainable health care program — one they can depend on," said TMA President Sue Bailey, MD, in calling on Congress to get to work now on a payment formula that works

TMA WINS INSURANCE CONSUMER PROTECTIONS

The Texas commissioner of insurance adopted three rules proposed by the Office of Public Insurance Counsel prohibiting discretionary clauses in insurance policies. Such clauses, already outlawed in 22 states, give insurers free rein to interpret policy terms and evaluate a patient's claim for benefits any way they choose. Public Insurance Counsel Deeia Beck praised TMA for being “instrumental in getting the new rules adopted.” In a letter supporting the rules, then-TMA President Bill Fleming, MD, wrote that discretionary clauses create a "fox guarding the henhouse situation that serves to provide the insurer with the authority to consistently deny benefits that a reasonable insured person would believe falls within the terms of the policy."

CONGRESS EXEMPTS DOCTORS FROM RED FLAGS RULE

Physicians aren’t their patients’ creditors and so don’t have to comply with the Federal Trade Commission’s onerous “red flags rules” to protect against identity theft. That’s what TMA, the American Medical Association, and other medical societies have argued for years. Last week, Congress agreed, sending the president a bill that exempts physicians from the rules.

MALONE HONORED AS TRAVIS PHYSICIAN OF THE YEAR

Congratulations to TMA President-Elect Bruce Malone, MD. His colleagues awarded the Austin orthopedic surgeon with the Travis County Medical Society’s Gold-Headed Cane. I was proud to join Dr. Malone, his wife Libby, and his many friends at the ceremony.

NEW TMA LOBBYIST IS A FAMILIAR FACE

TMA physicians and members of the Texas Legislature should feel right at home with TMA’s newest lobbyist. And he should feel right at home in our offices. Troy Alexander returns to TMA today to join our public affairs team again. He was director of TEXPAC from 1999 to 2003 before leaving to work as a top policy analyst for the speaker of the house. Welcome back, Troy.

Don’t Miss Dec. 31 Deadline to Nab 2010 PQRI, eRx Bonuses; TMA Can Help

Are you leaving a 4-percent Medicare bonus on the table this year? TMA-endorsed vendor DocSite offers members a free and simple way to satisfy the Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Initiative requirements and qualify for incentive payments. Contact the TMA HIT Helpline at (800) 880-5720 by Dec. 31 for a coupon to have your fees waived.


DON'T MISS DEC. 31 DEADLINE TO NAB 2010 PQRI, eRx BONUSES; TMA CAN HELP

Are you leaving a 4-percent Medicare bonus on the table this year? TMA-endorsed vendor DocSite offers members a free and simple way to satisfy the Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Initiative requirements and qualify for incentive payments. Contact the TMA HIT Helpline at (800) 880-5720 by Dec. 31 for a coupon to have your fees waived.

TENERY LAUNCHES HEALTH CARE BLOG

Never shy in sharing his opinions about health care, former TMA President Rob Tenery Jr., MD, has a new outlet for his thoughts: a blog called Echos for the Future: Reflections on the State of Healthcare. Do you blog? Join Dr. Tenery and the TMA-member bloggers featured on our website.

Monday, December 6, 2010

REPORT: TEXAS SHOULD CHANGE MEDICAID, NOT DROP IT

Texas shouldn’t — and can’t afford to — drop out of Medicaid, concludes a long-awaited report (PDF) from the Texas Health and Human Services Commission (HHSC) and the Texas Department of Insurance. If Texas were to leave Medicaid, the report concludes, up to 2.6 million Texans could lose health coverage, and physicians and providers in the state would lose $15 billion a year in federal aid. But current Medicaid spending patterns are unsustainable, and neither the report’s authors nor Gov. Rick Perry is satisfied with the status quo. “Texas, the states and the federal government would be much better served by increasing flexibility and innovation in Medicaid, even block granting funds to the states, so we can tailor Medicaid dollars to best serve the needs of Texas patients, families and taxpayers,” the governor said in a statement. “I have discussed these issues with other governors and policy experts, and will be working on ways to improve the utilization of Medicaid dollars in Texas.”

The new federal health law will make 1.5 to 2 million more Texans eligible for Medicaid beginning in 2014. Here’s how the report characterizes Texas’ ongoing predicament: “Without significant reform at the federal level, states are left facing a no-win dilemma. Opting out of Medicaid means giving up federal tax dollars paid by the state’s residents to provide health care for our most vulnerable residents. Staying in the program forces states to pay for a federally-mandated expansion of Medicaid with little control over the program’s ever-rising costs, exacerbating an already unsound financial situation.”

TMA will work with Governor Perry, legislative leaders, the Texas congressional delegation, and Health and Human Services Commissioner Tom Suehs to devise plans that trim Medicaid spending while providing cost-effective care to Medicaid recipients and adequate compensation to Texas physicians and providers in Texas.

ANOTHER MEDICARE MELTDOWN COMING JAN. 1

The one-month freeze on physicians’ Medicare rates that Congress passed and President Obama signed expires Dec. 31. Without further congressional action, Medicare payments will be cut 25 percent on Jan. 1. Several plans to freeze current rates for all of 2011 are circulating on Capitol Hill. Right now, the vehicle we’re watching most closely is the bill the lame duck Congress must pass to extend the Bush-era income tax rate cuts. The biggest roadblock is how Congress will pay the $15 billion cost of a one-year freeze. All of this uncertainty continues to frustrate Texas physicians and your patients. “Each time Congress plays this game of chicken, the cut to physicians grows deeper, and fear among our patients and physicians increases,” said TMA President Sue Bailey, MD. In Texas alone, more than 3 million patients’ health care could be put into jeopardy. Stay tuned.

TMA CME Program Wins High Honors, Six-Year Accreditation

I don’t brag often enough about our outstanding continuing medical education (CME) program. Not only does it ensure that TMA seminars, publications, and meetings provide you quality CME, but also it accredits the CME programs at 68 Texas hospitals, medical centers, and physician groups. The Accreditation Council for Continuing Medical Education (ACCME) completed its accreditation review of TMA’s CME program and gave us some great news. We passed all portions of the review with flying colors. “Yours is a learning organization and a change agent for the physicians you serve,” said ACCME Chief Executive Murray Kopelow, MD. “You have demonstrated an engagement with your environment in support of physician learning and change that is part of a system for quality improvement.” Our new accreditation is good for the maximum of six years.

ARE YOU GOING TO STAY IN MEDICARE IN 2011? WE CAN HELP YOU DECIDE

Physicians must decide their level of participation in the 2011 Medicare program by Dec. 31. The decision will be binding for the entire year, unless the Centers for Medicare & Medicaid Services reopens the enrollment period. We can’t tell you what to do, but we can offer you some help in making your decision. Check out our one-hour, recorded web seminar, “Evaluating Your Medicare Options,” on the TMA website. The webinar, featuring TMA’s in-house Medicare specialists, provides detailed information about participation options and the consequences of those choices. It also offers one hour of continuing medical education credit.